Nuria Rodríguez-Salas, Elia del Cerro, Teresa Rivera and Agustín Acevedo
A 49 years old woman was diagnosed of bilateral and multicentric infiltrating ductal breast carcinoma with a luminal A phenotype (Figure 1) and blastic bone metastatic spread. She had a very good response to hormonotherapy and monthly zoledronic acid without visceral spread or bone events for three years. Then she consulted because of progressively asthenia, anorexia, nausea, dizziness, orthostatic, occasional abdominal pain, increased thirst and frequent urination and altered sleep-wake cycles. On physical examination, she appeared pallid without any other remarkable finding.
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